Can I take medicine during my pregnancy?

You have a headache and you don't know what to do. Can you take some painkillers, or will they harm your baby? It is widely known that many drugs can have potentially harmful effects on an unborn baby. Therefore it is very important to check with a pharmacist or your GP before taking any medication when you are pregnant or trying for a baby.

Medicine maternity

Before pregnancy

Some women inadvertently take an over-the-counter medication before they know that they are pregnant. Often the manufacturer will state on the packaging that the drug should not be taken during pregnancy, but this is often just to be on the safe side for legal reasons. Your GP will be able to advise you if there is any risk to the developing baby. Paracetemol is thought to be safe for short term use for pain and fever during pregnancy. Hoever, do avoid anti-inflammatorys such as Ibruprofen. If you are in any doubts check with your pharmacist or midwife first. Occasionally a woman may get pregnant while taking the oral contraceptive pill, but most brands are thought not to be harmful to a foetus.

Any women taking medication for long-term conditions, such as asthma or diabetes, should consult their doctor as soon as possible, ideally before they conceive. In these situations any minor risks to the growing baby must be balanced against the likelihood of the illness getting worse if the medication is stopped. In many cases the medication will be continued, so it is essential that you do not stop any regular medication before seeking medical advice. In some women with conditions such as epilepsy and high blood pressure, it is known that some drugs are safer than others during pregnancy and so the medication may be changed. Women with ongoing health problems will be monitored closely during their pregnancy.

Before falling pregnant it is now recommended that you start taking folic acid, a vitamin supplement. It is known that taking a supplement of 400 micrograms of folic acid daily for the first 12 weeks of pregnancy reduces the risk of the baby developing a condition known as spina bifida. Iron supplements are not routinely recommended unless you are found to be anaemic after a blood test; this is because they often cause constipation as a side effect. It is best to eat a healthy mixed diet including green vegetables and some red meat to build up your iron stores.

The first 3 months

The first three months of pregnancy (first trimester) is the time when the baby's organs are being formed. The 3rd to the 11th week is therefore the stage when harmful drugs are most likely to cause birth defects. In the early 1960s, Thalidomide was prescribed to some pregnant women to combat morning sickness and caused limb malformations in affected babies. Since this tragedy, medication is rarely prescribed for morning sickness unless vomiting is excessive and there is a risk of dehydration occurring. If medication is needed for any problem during pregnancy, your GP will tend to choose an established drug that has been used safely for many years. New drugs are not necessarily unsafe, but there may be little information available about their use in pregnancy.

Months 3-9

In the second and third trimester (3-9 months) drugs may affect the growth of the baby or cause damage to the baby's tissues. Drugs taken towards the end of pregnancy or during labour can sometimes affect the newborn baby - it is wise to check with your GP at this stage in your pregnancy before you take any medicines, such as strong painkillers.

Treating minor illnesses

Pregnant women often suffer from minor ailments such as constipation and indigestion. To prevent constipation, a high-fibre diet is helpful, with lots of wholemeal bread, a bran-containing cereal and an increased fluid intake. If this does not solve the problem then lactulose, a mild laxative, is often prescribed. It is important that you do not strain as this can cause haemorrhoids (piles), which is another common problem during pregnancy. For indigestion and heartburn it is helpful to prop yourself up with extra pillows at bedtime or elevate the head of the bed using a pillow under the mattress. Mild antacid remedies, such as a magnesium trisilicate mixture, are safe to use.

For coughs and colds, try inhaling menthol and eucalyptus and drinking extra fluids and honey and lemon drinks. Paracetamol is safe for a temperature or headache. Most cough mixtures are known to actually have little beneficial effect, so aren't necessary.

If antibiotics are needed to treat a bacterial infection during pregnancy, such as cystitis, several antibiotics are known to be safe, including penicillin-based drugs. For thrush, your GP will prescribe a vaginal anti-fungal pessary, but oral medication should be avoided.

The best advice is to avoid all medications wherever possible during pregnancy. It is important to remember that this also applies to herbal remedies or supplements from health food shops. In this situation 'natural' does not necessarily mean 'healthy'. These substances are not regulated and little is known about their safety during pregnancy.

Doctors only prescribe medication during pregnancy if the benefits to the mother clearly outweigh any possible risk to the baby. Remember to tell your GP before he or she issues a prescription, if there is any possibility that you may be pregnant.

For more information please visit the NHS website at www.nhsdirect.nhs.uk.

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